Instructor-Coach

==The Instructor-Coach-Observer Continuum==

Abstract: Trainees specify some of the client and setting characteristics that present counseling challenges for them, and the process elicits discussion of helpful techniques.

Overview: The aim is to teach the spirit of MI, without immersing practitioners immediately in a foreign MI language. To use terms to convey the spirit that might have them think, “Oh yes, I see, there are different ways of talking to people about change….”.

Guidelines: Draw the continuum on the board or paper and ask participants how these three roles are different. What does an instructor do? (Teach, tell, direct, show expertise) What does an observer do? (watch, listen, not participate actively at the moment). What does a coach do? (encourages, is patient, supportive, guiding). How would they like for you to work with them as an Instructor, as a Coach, or as an Observer who listens to their own experience? The likely response is “Some of each,” and indeed that is what you are likely to do. You can also ask participants to tell you where they spend most of their time (on this scale) in their own daily work.

Notes: Obviously there is a straightforward parallel to the Direct-Guide-Follow continuum, along which MI lies in the middle and involves a flexible and skillful blend of directing and following.

Thanks to: Steve Rollnick http://www.motivationalinterview.org/mint/MINT10_1.pdf

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==The Instructor-Coach Continuum: for healthcare practitioners==

I (Steve Rollnick) used this right at the beginning of the first of four training sessions among cardiac rehab staff (right after the 3-in-a-row exercise, although its not essential to do this first).

'''Aim''': to teach the spirit of MI, without immersing practitioners in a foreign MI language. To use terms to convey the spirit that might have them think, “Oh yes, I see, there’s another way of talking to people about change….”.

'''Preparation''': I told them that MI was a style of counselling. The workshop had been advertised as an MI one, so I had to come out with this straight away (otherwise I might not said this just yet).

'''The exercise''': I drew this on the board, one half in red, the other in blue. I then simply asked them what characterised an instructor (compared to a coach). Drew up the list below the word
INSTRUCTOR, then did the same for COACH. So it looked a bit like this, although the list for each was much longer:

INSTRUCTOR
tells people
knows why people should change
knows how they should change
an expert
etc

COACH
encourages
is patient
supportive
listens
etc

'''The next steps''':
• I was really delighted when “listening” came up, as you might imagine.
• I asked them what number on the scale characterised their approach to the pre-workshop simulated consultation (answers like “I moved between different numbers”; “a 3 on the instructor side”, said one gormless person proudly!).
• I said I would ask them again as we went through the training sessions.
• I asked them when was the best time in their everyday practice, to be like an instructor (flooded with legitimate scenarios). And like a coach? Some interesting answers.
• I asked them what was the best way to get my son to have a bath and why I got into trouble when I instructed him (we all agreed that coaching avoided threats to his autonomy).
• I showed them the brilliant Butler video clip of instruction with a cardiac patient (aha, so
we concluded that instruction doesn’t always work with lifestyle conversations)
• I turned to coaching, and asked them what was the skill on the right hand side that was the most difficult to learn? LISTENING!
• So we spent the afternoon on listening, and I told them that MI was like coaching and that the goal of the workshop was not to get them to adopt a new style (which is simply not suited to their setting). Rather, it was to increase their flexibility, so that they made conscious decisions about when to use what style.

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from Motivational Interviewing Training for New Trainers (TNT), Resources for Trainers, http://www.motivationalinterviewing.org/